Provider Demographics
NPI:1073133567
Name:SUNRISE ADULT DAY CARE
Entity Type:Organization
Organization Name:SUNRISE ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUNHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-468-9994
Mailing Address - Street 1:3930 LEON AVE # 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2814
Mailing Address - Country:US
Mailing Address - Phone:702-466-1900
Mailing Address - Fax:702-916-4844
Practice Address - Street 1:3930 LEON AVE # 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2814
Practice Address - Country:US
Practice Address - Phone:702-466-1900
Practice Address - Fax:702-916-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care